Lateral Vs Classical Approach of Supraclavicular Brachial Plexus Block for Orthopedic Surgeries below Mid-Humerus: A Comparative Study.

ABSTRACT

Introduction: Supraclavicular brachial plexus blockwith classical approach is used to provide anaesthesia fororthopaedic upper limb surgeries. This approach is safe but notdevoid of complication, therefore we compared a alternativelateral approach with classical approach in terms of sensoryand motor blockade, tourniquet tolerance and complication.Material and Methods: After obtaining the ethics committeeapproval 64 patients posted for orthopaedic surgeries belowmid humerus under supraclavicular block were enrolled. Theywere divided into two groups (32 each), Group C receivedclassical approach and Group L received lateral approachwith the help of nerve stimulator. A mixture of adrenalized2% lignocaine (5-7mg/kg) and plain 0.5% bupivacaine (2mg/kg)(total volume 30 ml) was used. Onset time of sensory andmotor block, duration of sensory and motor block, durationof analgesia, tourniquet tolerance and complications (if any)were noted and compared in both the groups. Quantitative datawere compared by using unpaired T test and qualitative databy using Chi-Square test and Fisher’s Exact test (2X2 tables).Results: The mean times to onset of sensory and motorblockade and the mean duration of sensory and motorblockade did not differ between the two groups. Mean durationof analgesia with lateral approach is found to be longer butstatistically not significant. Tourniquet tolerance was goodand no pneumothorax observed in lateral approach.Conclusion: Lateral approach has shown to be a safealternative to classical approach for supraclavicular brachialplexus block in terms of adequacy of block, tourniquettolerance and complications.